sábado, 4 de octubre de 2014

Avian Flu H7N9 in China - Watch - Level 1, Practice Usual Precautions - Travel Health Notices | Travelers' Health | CDC

Avian Flu H7N9 in China - Watch - Level 1, Practice Usual Precautions - Travel Health Notices | Travelers' Health | CDC



CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.

Avian Flu (H7N9) in China

Warning - Level 3, Avoid Nonessential Travel
Alert - Level 2, Practice Enhanced Precautions
Watch - Level 1, Practice Usual Precautions
Updated: August 04, 2014

What is the current situation?

According to the World Health Organization (WHO)External Web Site Icon, there have been more than 450 confirmed human cases of avian influenza A (H7N9) with more than 170 deaths reported from China since April 2013. There is also 1 case from Malaysia.
CDC recommends travelers not touch animals, eat food that is fully cooked, and practice regular hand washing to protect themselves.

What is H7N9?

H7N9 in humans was first reported in March 2013. Symptoms include fever, cough, and shortness of breath. Infection with the new virus has resulted in severe respiratory illness and, in some cases, death. Chinese authorities are conducting animal and human health investigations to learn more about this situation. Available evidence suggests that most people have been infected with the virus after having contact with infected poultry or contaminated environments.

What can travelers and Americans living in China do to protect themselves?

There is currently no vaccine to prevent H7N9. CDC is repeating its standard advice to travelers and Americans living in China to follow good hand hygiene and food safety practices and to avoid contact with animals.
  • Do not touch birds, pigs, or other animals.
    • Do not touch animals whether they are alive or dead.
    • Avoid live bird or poultry markets.
    • Avoid other markets or farms with animals (wet markets).
  • Eat food that is fully cooked.
    • Eat meat and poultry that is fully cooked (not pink) and served hot.
    • Eat hard-cooked eggs (not runny).
    • Don’t eat or drink dishes that include blood from any animal.
    • Don’t eat food from street vendors.
  • Practice hygiene and cleanliness:
    • Wash your hands often.
    • If soap and water aren’t available, clean your hands with hand sanitizer containing at least 60% alcohol.
    • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
    • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
    • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups, with people who are sick.
  • See a doctor if you become sick during or after travel to China.
    • See a doctor right away if you become sick with fever, coughing, or shortness of breath.
    • If you get sick while you are still in China, visit the US Department of State websiteExternal Web Site Icon to find a list of local doctors and hospitals. Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website (www.jointcommissioninternational.orgExternal Web Site Icon).
    • According to a messageExternal Web Site Icon issued by the US Embassy in BeijingExternal Web Site Icon, patients with fever and other symptoms of flu will be sent to designated hospitals for evaluation.
    • Delay your travel home until after you have recovered or your doctor says it is okay to travel.
    • If you get sick with fever, coughing, or shortness of breath after you return to the United States, be sure to tell your doctor about your recent travel to China.

Clinician information:

Clinicians should consider the possibility of avian influenza A (H7N9) virus infection in persons presenting with respiratory illness within 10 days of an appropriate travel or exposure history. Although the majority of H7N9 cases have resulted in severe respiratory illness in adults, infection with this virus may cause mild illness in some and may cause illness in children as well. Influenza diagnostic testing in patients with respiratory illness for whom an etiology has not been confirmed may identify human cases of avian influenza A virus infection or new cases of variant influenza in the United States. If patients are infected with H7N9 virus, reverse-transcription polymerase chain reaction (RT-PCR) testing will be positive for influenza A but will be unsubtypeable. Clinicians suspecting H7N9 infection should obtain appropriate specimens and notify their local or state health department promptly. State health departments should notify CDC of suspected cases within 24 hours. For more information, see the Health Alert Notice issued April 5, 2013.
Because of the potential severity of illness associated with H7N9 virus infection, it is recommended that all confirmed and probable H7N9 case-patients and H7N9 case-patients under investigation receive antiviral treatment with a neuraminidase inhibitor as early as possible. Treatment should be initiated even if it is more than 48 hours after onset of illness. Laboratory testing and initiation of antiviral treatment should occur simultaneously. For more information, see CDC’s interim recommendations on the use of antivirals in treating H7N9 influenza.

Additional Information:



10/02/2014 12:22 PM EDT

Source: Centers for Disease Control and Prevention
Related MedlinePlus Page: Bird Flu
10/02/2014 12:22 PM EDT

Source: Centers for Disease Control and Prevention
Related MedlinePlus Page: Bird Flu

CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.

Influenza Type A Viruses and Subtypes


There are three types of influenza viruses: A, B and C. Human influenza A and B viruses cause seasonal epidemics, generally between October and May, of disease in the United States.
Wild aquatic birds are the natural hosts for all known influenza type A viruses - particularly certain wild ducks, geese, swans, gulls, shorebirds and terns. Influenza type A viruses can infect people, birds, pigs, horses, dogs, marine mammals, and other animals. Influenza type A viruses are divided into subtypes on the basis of two proteins on the surface of the virus: hemagglutinin (HA) and neuraminidase (NA). For example, an “H7N2 virus” designates an influenza A virus subtype that has an HA 7 protein and an NA 2 protein. Similarly an “H5N1” virus has an HA 5 protein and an NA 1 protein. There are 17 known HA subtypes and 10 known NA subtypes. Many different combinations of HA and NA proteins are possible. All known subtypes of influenza A viruses can infect birds, except subtype H17N10 which has only been found in bats. Only two influenza A virus subtypes (i.e., H1N1, and H3N2) are currently in general circulation among people. Some subtypes are found in other infected animal species. For example, H7N7 and H3N8 virus infections can cause illness in horses, and H3N8 virus infection can also cause illness in dogs.
Avian influenza A viruses are classified into two categories (low pathogenic and highly pathogenic) that refer to their ability to cause severe disease, based upon molecular characteristics of the virus and mortality in birds under experimental conditions. Infection of poultry with low pathogenic avian influenza A (LPAI) viruses may cause no disease or mild illness (such as ruffled feathers and a drop in egg production) and may not be detected. Infection of poultry with highly pathogenic avian influenza A (HPAI) viruses can cause severe disease with high mortality. Both HPAI and LPAI viruses can spread rapidly through poultry flocks. HPAI virus infection can cause disease that affects multiple internal organs with mortality up to 90-100% in chickens, often within 48 hours. However, ducks can be infected without any signs of illness. There are genetic and antigenic differences between the influenza A virus subtypes that typically infect only birds and those that can infect birds and people.
Three prominent subtypes of avian influenza A viruses that are known to infect both birds and people are:

Influenza A H5

Nine potential subtypes of H5 viruses are known (H5N1, H5N2, H5N3, H5N4, H5N5, H5N6, H5N7, H5N8, and H5N9). Most H5 viruses identified worldwide in wild birds and poultry are LPAI viruses. Sporadic H5 virus infection of humans, such as with highly pathogenic avian influenza A (H5N1) viruses currently circulating among poultry in Asia and the Middle East have been reported in 15 countries, often resulting in severe pneumonia with approximately 60% mortality worldwide.

Influenza A H7

Nine potential subtypes of H7 viruses are known (H7N1, H7N2, H7N3, H7N4, H7N5, H7N6, H7N7, H7N8, and H7N9). Most H7 viruses identified worldwide in wild birds and poultry are LPAI viruses. H7 virus infection in humans is uncommon, but has been documented in persons who have direct contact with infected birds, especially during outbreaks of H7 virus among poultry. Illness in humans may include conjunctivitis and/or upper respiratory tract symptoms.
In humans, LPAI (H7N2, H7N3, H7N7) virus infections have caused mild to moderate illness.
HPAI (H7N3, H7N7) virus infections have caused mild to severe and fatal illness.
On April 1, 2013, the first known human cases of infection with avian influenza H7N9 viruses were reported. These were associated with severe respiratory illness and death.

Influenza A H9

Nine potential subtypes of H9 are known (H9N1, H9N2, H9N3, H9N4, H9N5, H9N6, H9N7, H9N8, and H9N9); all H9 viruses identified worldwide in wild birds and poultry are LPAI viruses. H9N2 virus has been detected in bird populations in Asia, Europe, the Middle East and Africa. Rare, sporadic H9N2 virus infections of humans have been reported to cause generally mild upper respiratory tract illness.

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